We completed all the analyses last year and reported the findings in last years annual progress report. We plan to submit a manuscript based on these findings. Due to data limitations, studying non-elderly nursing home population can be challenging. While the only public-use National Nursing Home Survey (NNHS) collects data on nursing homes, their services, staff, and residents in the United States, the most recent survey (2004 NNHS) was conducted more than five years ago. Therefore, we do not know if the composition and characteristics of non-elderly nursing residents have changed over time. Moreover, the 1997 and 1999 NNHS are the only two public-use files that contain information of nursing home discharges. We dont know if they truly reflect discharge outcomes among current nursing home population, in particular, non-elderly population. Since the NNHS does not collect cost information, the total cost and the effectiveness of nursing home care cannot be estimated. To address this issue, we plan to conduct a similar study using claim-based data provided by the Centers for Medicare and Medicaid (CMS). This project will be carried out under an inter-agency agreement between the NIH Clinical Center and the CMS.